title: Increases in gonorrhea among high school students following hurricane Katrina.
abstract: OBJECTIVE
  To determine the prevalence of Neisseria gonorrhoeae in a student population before hurricane Katrina and after their residential neighbourhoods were devastated in the wake of the hurricane.
  
  
  METHODS
  Students in a New Orleans public high school were offered urine screening for N gonorrhoeae and Chlamydia trachomatis using nucleic acid amplification tests before (n = 346) and after (n = 333) hurricane Katrina. Based on studies showing gonorrhea clustering in physically deteriorated neighbourhoods, it was hypothesised that the post-Katrina gonorrhea prevalence would be higher among students whose neighbourhoods still showed signs of deterioration in the aftermath of the hurricane.
  
  
  RESULTS
  Before and after hurricane Katrina, the prevalence of gonorrhea increased from 2.3% (8/346, 95% CI 1.3% to 4.6%) to 5.1% (17/333, 95% CI 3.1% to 8.2%), respectively (one-sided p = 0.027). In logistic regression of gonorrhea controlling for gender, age, chlamydia infection and exposure to hurricane-affected residential neighbourhood conditions, gonorrhea was significantly associated with female gender (odds ratio (OR) 2.6, 95% CI 1.0 to 6.3; p = 0.04) and with chlamydia infection (OR 9.2, 95% CI 3.9 to 21.7; p<0.001). Although of weak statistical significance, there was a strong independent positive trend toward testing positive for gonorrhea after the hurricane (OR 2.2, 95% CI 0.9 to 5.4; p = 0.09).
  
  
  CONCLUSIONS
  The analysis indicates that the odds of testing positive for gonorrhea more than doubled among students after the hurricane, indicating that surveillance activities should be restored to monitor sexually transmitted infections (STIs) among at-risk populations. Redoubled efforts should be put into STI screening programmes as soon as possible following natural disasters to prevent resurgent STI incidence rates.
authors.affiliation: School of Medicine, Department of Medicine, Section of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. mnsuam@lsuhsc.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Nsuami
authors.forename: S N
authors.initials: SN
authors.lastname: Taylor
authors.forename: B S
authors.initials: BS
authors.lastname: Smith
authors.forename: D H
authors.initials: DH
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D055867:Cyclonic Storms; D004190:Disasters; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D006801:Humans; D008297:Male; D008403:Mass Screening; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D055820:New Orleans / Q000453:epidemiology; D021141:Nucleic Acid Amplification Techniques; D015995:Prevalence; D012111:Residence Characteristics; D012572:School Health Services; D013334:Students